Community Health Nursing Evaluation and Diagnosis - Essay Example

 Community Health Nursing Jefferson County Demographic Profile Jefferson County is located close to the western side of Pennsylvania. Jefferson County has a total population of 45,725 as of 2006 (Pennsylvania Health Department, 2008). As of 2006, 17.9% of the total population are more than 65 years of age (ibid). With the median age of 40.9 years old. (See Table I – Estimated Population by Age and Sex as of 2006) Table I – Estimated Population by Age and Sex as of 2006 Age Total Male Female All Ages 45,725 22,406 23,319 Under 5 y/o 2,485 1,304 1,181 5 – 14 5,535 2,891 2,644 15 – 24 6,005 3,126 2,879 25 – 34 5,272 2,677 2,595 25 – 44 6,011 3,350 3,407 45 – 54 6,757 3,350 3,407 55 – 64 5,489 2,622 2,867 65 – 74 4,323 1,931 2,392 75+ 3,848 1,473 2,375 Source: Pennsylvania Department of Health, 2008 Jefferson County Health Department (Pennsylvania) has been very focused on promoting health preparedness and response to public health emergency. Despite the effort of Jefferson County Health Department to promote the health and wellness of the community members, the total number of death is 537 with 11.7% crude death rate per 1,000 population back in 2006 (Pennsylvania Department of Health, 2008). Back in 2006, the Pennsylvania Department of Health reported that the mortality rate throughout Jefferson County was as high as 11.7% crude death rate per 1,000 population. Among the major causes of death between 2004 to 2006 includes diseases of the heart, malignant neoplasms or cancer, cerebrovascular diseases or stroke, chronic lower respiratory diseases, accidents, diabetes mellitus, Alzheimer’s disease, nephritis / nephrosis, influenza and pneumonia, and septicemia. (See Table II – Major Causes of Mortality in Jefferson County below) Table II – Major Causes of Mortality in Jefferson County Causes of Death Number of Death per 100,000 Population Diseases of the Heart 474 Malignant Neoplasms or Cancer 339 Cerebrovascular Diseases / Stroke 124 Chronic Lower Respiratory Diseases 72 Accidents 57 Diabetes Mellitus 64 Alzheimer’s Disease 43 Nephritis Nephritic Syndrome and Nephrosis 54 Influenza and Pneumonia 29 Septicemia 30 Source: Pennsylvania Department of Health, 2008 With regards to controllable and preventable diseases like diabetes mellitus and pneumonia, environmental factors related to air pollution and lifestyle such as the habit of smoking and drinking are among the common causes of life-threatening diseases. As reported by Pennsylvania Department of Health (2008), among the common health risk factors of people living in Jefferson County includes: (1) overweight (65%); (2) had flu shot in past year – 50 & older (51%); (3) obese (28%); (4) current smoker (23%); (5) ever test for HIV (19%) & fair or poor general health (19%); (6) no health insurance (13%); (7) ever told they have diabetes (9%); and (8) currently has asthma and heavy drinking (7%) (Pennsylvania Health Department, 2008). Community Diagnosis No. 1 With regards to mortality, the first community diagnosis is the coronary heart disease or diseases of the heart. Coronary heart disease is basically one form of heart diseases. Based on Healthy People 2010, the death rate of coronary heart disease per 100,000 in Jefferson County is 168.8 between the years 2002 – 2006 as compared to Healthy People 2010 goal of 166. The formation of coronary heart disease can result to stroke. In Jefferson County, it has been reported that the stroke death rate is 58.4 during the same year as compared to Healthy People 2010 goal of 48 (Healthy People 2010, 2009). Aside from the uncontrollable risk factors of heart diseases including gender, age, family history of heart disease, post-menopausal, and race; other risk factors like smoking, high LDL or bad cholesterol and low HDL or good cholesterol, high blood pressure, lack of physical activity causing obesity, diabetes, and excessive stress and anger can be easily controlled to prevent the development of heart diseases (WebMD, 2009). Goals By year 2010, the incidence of death related to cerebrovascular heart disease in Jefferson County will decrease from 168.8 between the years 2002 – 2006 down to 166. Increase the number of people in Jefferson County who regularly does the following: a. Weight conscious by increasing physical activity; b. Health conscious by observing the types of foods they eat; c. Minimize excessive stress by effective management like the practice of relaxation techniques including Tai Chi, body massage, or yoga. (WebMD, 2009) 3. Increase the number of people who regularly check their blood pressure. 4. Increase the people’s knowledge on how to effectively prevent the incidence of developing heart diseases. Nursing Intervention Educate the community members within the Jefferson County regarding the risk factors of heart diseases and prevention methods using posters, flyers, newspaper articles, and health teaching. Encourage each individual to be conscious of eating high cholesterol foods through dietary reduction of cholesterol intake, exercise regularly, smoking cessation, and the administration of medication when necessary. Educate the community members regarding the early detection of heart diseases by organizing a once a month lecture or inter-office training seminars; Encourage the community members to seek immediate medical help as soon as they have observed the signs and symptoms of heart diseases such as high blood pressure, hypertension, or high blood glucose which could result from adhering to treatment regiment; Inform the community members regarding the advantages of heart disease prevention vs. curative treatment. Encourage the community members who has been diagnosed with heart diseases to comply with the treatment protocols by home health referrals; Organize heart disease support group to assist the patients in dealing with their physical and emotional imbalances related to the said disease. Evaluation Evaluate the incidence of heart disease in year 2010 to determine whether or not the goal of decreasing the death rate related to heart diseases from 168.8 between the years 2002 – 2006 down to 166 has been successful. Re-evaluate the morbidity and mortality rate related to heart diseases after 5 years to ensure that the goal of Healthy People 2010 has been reached. Community Diagnosis No. 2 The second community diagnosis is malignant neoplasms or cancer. Based on Healthy People 2010, the death rate of cancer per 100,000 in Jefferson County is 183.0 between the years 2002 – 2006 as compared to Healthy People 2010 goal of 159.9 (Healthy People 2010, 2009). Among the common types of cancer includes cancer related to the following: (1) lungs; (2) breast; (3) cervical; (4) colorectal; (5) prostate; and (6) melanoma or skin among others. Aside from the risk factors of cancer including age, family history of cancer, exposure to tobacco, sunlight, ionizing radiation, certain chemicals or other substances, some viruses and bacteria, certain hormones, alcohol, poor diet, lack of exercise, or being overweight. (Medicine Net, 2009; National Cancer Institute, 2009) Goals 1. By year 2010, the incidence of death related to cancer in Jefferson County will decrease from 183.0 between the years 2002 – 2006 down to 159.9. 2. Increase the number of people in Jefferson County who regularly does the following: a. Weight conscious by increasing physical activity; b. Health conscious by observing the types of foods they eat; c. Minimize or preventing exposure tobacco, alcohol, sunlight, ionizing radiation, chemicals and other substances, including viruses and bacteria. (Medicine Net, 2009) 3. Increase the number of people who regularly check signs and symptoms like tumor, fever, tiredness or fatigue, and weight loss. 4. Increase the people’s knowledge on how to effectively prevent the incidence of developing cancer. Nursing Intervention Educate the community members within the Jefferson County regarding the risk factors of cancer and prevention methods using posters, flyers, newspaper articles, and health teaching. Encourage each individual to be conscious with the type of foods they eat including the presence of acrylamide in food (National Cancer Institute, 2009a), artificial sweeteners (National Cancer Institute, 2006), and the presence of heterocyclic amines in meat cooked in high temperature (National Cancer Institute, 2004) aside from reducing exposure to cell phone radiation which transmit radiofrequency (RF) energy into the human body (National Cancer Institute, 2008). Educate the community members regarding the early detection of cancer by organizing a once a month lecture or inter-office training seminars; Assess patient for infection, reduced white blood cell count, bleeding, skin problems caused by radiation therapy, nutritional problems, pain, fatigue, and psychological stress; Encourage the community members to regularly undergo check-up to detect any signs and symptoms of cancer at an early stage; Inform the community physicians regarding the advantages of cancer prevention vs. curative treatment. Encourage the community members who has been diagnosed with cancer to comply with the treatment protocols like chemotherapy among others; Organize cancer support group to assist the patients in dealing with their physical and emotional imbalances related to the said disease. Evaluation Evaluate the incidence of cancer in year 2010 to determine whether or not the goal of decreasing the death rate related to cancer from 183.0 between the years 2002 – 2006 down to 159.9 has been successful. Re-evaluate the morbidity and mortality rate related to cancer after 5 years to ensure that the goal of Healthy People 2010 has been reached. References Healthy People 2010. (2009). Retrieved April 26, 2009, from http://www.dsf.health.state.pa.us/health/lib/health/HP2010/HP2010-Jefferson.pdf Medicine Net. (2009). Retrieved April 25, 2009, from Cancer Risk Factors: http://www.medicinenet.com/cancer_causes/article.htm National Cancer Institute. (2004, September 15). Retrieved April 26, 2009, from Heterocyclic Amines in Cooked Meats: http://www.cancer.gov/cancertopics/factsheet/Risk/heterocyclic-amines National Cancer Institute. (2006, October 5). Retrieved April 25, 2009, from Artificial Sweeteners and Cancer: Questions and Answers: http://www.cancer.gov/cancertopics/factsheet/Risk/artificial-sweeteners National Cancer Institute. (2008, September 3). Retrieved April 25, 2009, from Cellular Telephone Use and Cancer Risk: http://www.cancer.gov/cancertopics/factsheet/Risk/cellphones National Cancer Institute. (2009). Retrieved April 25, 2009, from Cancer Causes and Risk Factors : http://www.cancer.gov/cancertopics/prevention-genetics-causes/causes National Cancer Institute. (2009a). Retrieved April 25, 2009, from Acrylamide in Food and Cancer Risk: http://www.cancer.gov/cancertopics/factsheet/risk/acrylamide-in-food Pennsylvania Health Department. (2008). Retrieved April 26, 2009, from Jefferson County - Health Profile 2008: http://www.dsf.health.state.pa.us/health/lib/health/countyprofiles/2008/2008_Health_Profiles_(jefferson).pdf WebMD. (2009). Retrieved April 25, 2009, from Risk Factors for Heart Disease: http://www.webmd.com/heart-disease/risk-factors-heart-disease Read More